The impact of medical student research as a discussion topic during the residency interview process

doi:10.21203/rs.3.rs-310816/v1

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Research Article

The impact of medical student research as a discussion topic during the residency interview process

https://doi.org/10.21203/rs.3.rs-310816/v1

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Background

Students with a greater number of research experiences are more successful in the National Residency Match Program (NRMP.) As a result, approximately two-thirds of allopathic medical schools have implemented a scholarly research project (SP) as a part of their curriculum. While inclusion of a SP in the medical school curriculum increases research productivity, literature to date has not investigated its ability to provide students with a means to communicate their scholarly strengths to residency programs during interview discussions.

Methods

123 students from the graduating class of 2019 and 2020 at the University of Arizona College of Medicine Phoenix (UACOMP) completed a 17-question survey examining the student’s SP and whether they completed additional research.

Results

27% of interviewers (SD 27.0) asked students about their SP and 41% of interviewers (SD 32.0) asked students about additional non-SP research. 40% of interviewers asked about research overall to include SP and/or non-SP research. A greater percentage of interviewers (50%, SD 26.2) asked students about their SP if they had undertaken additional research compared to interviewers of students who did not undertake additional research (29%, SD 28.4, p = 0.0237). A greater percentage of interviewers at academic institutions (31%, SD 27.9) asked students about their SP, compared with a smaller percentage of interviewers at predominantly non-academic programs (22%, SD 25.5, p = 0.0054). There were no significant differences in the proportion of interviewers asking about the SP based on the type of specialty, competitiveness of specialty, topic relatedness of project, and publication/presentation status of project.

Conclusion

Student research experiences may serve as a meaningful discussion topic during the residency interview. Approximately one-third of interviewers ask about the SP regardless of specialty, research topic, and publication/presentation status of the project. Students with additional research experiences beyond their SP may experience a higher percentage of interviewers asking about their SP. Also, students applying to predominantly academic programs may experience a higher proportion of interview questions about research compared to peers interviewing at non-academic programs.

Educational Philosophy and Theory

Internal Medicine

medical education

scholarly research

residency interview

residency match

As the competitiveness of the National Residency Match Program (NRMP) increases each year, medical students are undertaking greater numbers of research experiences to increase the competitiveness of their application. In the 2020 Match, U.S. M.D. seniors reported an average of 3.6 research experiences with a higher mean number of research experiences for competitive specialties including dermatology, interventional radiology, neurosurgery, otolaryngology, orthopedic surgery, and radiation oncology.¹ For almost all specialties, matched U.S. MD seniors had on average greater numbers of research experiences, research conference presentations, and publications compared to students who did not successfully match.¹ Even prior to the match, authorship of one or more publications is associated with a greater number of interview invitations for integrated plastic surgery applicants² and over 90% of general surgery program directors state that they consider basic and clinical research almost always or all the time when evaluating candidates.³

In an effort to prepare medical students to be competitive in the Match, almost two-thirds of allopathic medical schools have implemented a scholarly research project as a component of their curriculum with approximately one-third of schools making completion of this scholarly research project mandatory for graduation.⁴ The University of Pittsburg School of Medicine assessed the research productivity of its students before and after the implementation of a mandatory scholarly project and while noting only a modest rise in the number of students engaged in research, they identified a significant increase in the number of students with publications and first authorship.⁵ Research experience, publications, and conference presentations clearly impacts an applicant’s success in the Match, and this may motivate medical schools to make more research opportunities available for students.

The objectives of mandatory scholarly research projects are to produce critical thinking life-long learners with self-directed independent learning skills, writing skills, and an understanding of the scientific method. These key objectives of scholarly project curricula are also highly desired characteristics in residency applicants.⁶ The NRMP data suggest that research experience is an important component of the residency application. This study sought to determine if the scholarly project serves as a meaningful topic of discussion during the residency interview process and a means for students to demonstrate scholarly and critical thinking skills. We hypothesized that regardless of the research topic or publication outcome, a student’s scholarly research project would serve as a meaningful discussion topic during the interview.

The University of Arizona College of Medicine-Phoenix (UACOMP) requires students to complete a mandatory 4-year, longitudinal scholarly project (SP) that is hypothesis driven and culminates in a poster presentation and written thesis. The present study surveyed fourth year medical students from the graduating class of 2019 and 2020 at UACOMP using an online survey approximately two months following completion of residency interviews and two weeks prior to the Match. Students were allotted 20 minutes during an in-person session on campus to complete the 17-question survey. This survey study was approved by the Institutional Review Board at the University of Arizona. Survey completion was optional, anonymous, and all participants electronically agreed to an informed consent prior to beginning the survey and could exit the survey at any time.

The survey examined the student’s SP, volunteer experiences, work experiences, and non-SP research. The survey also determined if students published or presented research at a national conference, and whether the research topics related to the specialty sought by the medical student. Students were asked to estimate the number of interviewers they met with during the interview process and the number of interviewers who asked them about their SP, volunteer experiences, work experiences, and non-SP research. The survey also gathered baseline characteristics of students including specialty and predominant type of program the student interviewed with – academic or community. A full list of survey questions can be found in Fig. 1.

Statistical Analysis

Survey results were collapsed across both classes to form a total survey population of 123 participants as there were no significant differences between the classes. Publication, presentation at a national conference, and topic relatedness of research to chosen specialty for both SP and non-SP research were reported as frequencies with percentages. The proportion of interviewers asking about SP, volunteer experiences, work experiences and non-SP research was calculated for each survey participant. These were then treated as a continuous variable and reported as means with standard deviations. Two-proportion z-tests with a significance level of 0.05 was used to determine whether the hypothesized difference between proportions of interviewers asking about SP differed significantly based on specialty type, competitiveness of specialty, publication of SP, presentation of SP, topic of SP, undertaking of additional non-SP research, and application to predominantly academic programs.

Baseline Characteristics

A total of 123 students participated in the survey from the graduating class of 2019 and 2020 at the UACOMP. A high percentage of the students completed the survey, with 62 out of the 67 students in the class of 2019 (92.5%) and 61 out of the 82 students in the class of 2020 (74.3%). The overall survey response rate was 82.6%. The baseline characteristics for the survey participants from the Class of 2019 and 2020 can be found in Table 1. There were no significant differences in baseline characteristics with roughly two-fifths of the survey population interviewing for primary care (40.7%) and three-fifths in non-primary care specialties (59.3%). Approximately one-fifth of the survey participants (18.7%) interviewed in more competitive specialties designated by having an annual number of applicants per position greater than 1.35.

Table 1

Baseline Characteristics
	Class of 2019	Class of 2020	Total
Number of Students	62	61	123
Primary Care	30	20	50 (41%)
Family Medicine	7	7	14
Internal Medicine	14	6	20
Internal Medicine-Pediatrics	1	0	1
Pediatrics	8	7	15
Non-Primary Care	32	41	73 (59%)
Anesthesiology	7	2	9
Child Neurology	0	1	1
Diagnostic Radiology	5	4	9
Emergency Medicine	7	12	19
General Surgery*	1	3	4
Neurology	1	1	2
Neurosurgery*	2	0	2
OB/GYN	3	2	5
Ophthalmology*	0	2	2
Orthopedic Surgery*	1	5	6
Otolaryngology*	2	3	5
Pathology	1	0	1
Plastic Surgery*	0	2	2
Psychiatry	1	3	4
Urology*	1	1	2
* more competitive specialties denoted by annual number of applicants per position > 1.35

All students completed the mandatory SP curriculum, and their project title was included in their Medical Student Performance Evaluation (MSPE) letter as part of their residency application. The survey showed that 65% of students reported undertaking additional research not related to their mandatory SP. The research characteristics of students’ SP and non-SP research including publication status, presentation at a national conference, and topic relatedness to chosen specialty can be found in Table 2.

Table 2

Research Characteristics
	Total Number of Students (%)
Scholarly Project	123 (100%)
Published	59 (48%)
Presented at National Conference	41 (33%)
Topic Related to Chosen Specialty	58 (47%)
Additional Research	80 (65%)
Published	62 (78%)
Presented at National Conference	39 (49%)
Topic Related to Chosen Specialty	62 (78%)

SP Impact on the Interview Conversation

The survey revealed that 40% of interviewers (SD 30.7) asked students about their research experiences, while 41% of interviewers (SD 42.7) asked students about volunteering experiences, and 35% of interviewers (SD 32.9) asked students about work experiences as shown in Table 3. Specifically, with regards to the type of research discussed, 27% (SD 27.0) versus 41% (SD 32.0) of interviewers asked about the student’s SP and additional research, respectively.

Table 3

Mean Reported Proportion of Interviewers Asking about Research, Volunteering & Work Experience
	Proportion of Interviewers (%, SD)
Research Overall	40% (30.7)
Scholarly Project	27% (27.0)
Additional Research	40% (32.0)
Volunteering	41% (42.7)
Work Experiences	35% (32.9)

Survey data was analyzed to determine if the proportion of interviewers asking about a student’s SP differed based on seven relevant factors shown in Table 4. There were no significant differences between the proportion of interviewers asking about a student’s SP based on the type of specialty or competitiveness of the specialty. Additionally, there were no significant differences between the proportion of interviewers asking about a student’s SP based on the publication or presentation status of the project or whether the topic was related to the student’s chosen specialty. However, the amount of research experience undertaken by the student outside of the SP had a significant impact on the proportion of interviewers asking about the SP. Results showed that 50% of interviewers (SD 26.2) asked students about their SP if they had undertaken additional research outside of their SP compared to 29% of interviewers (SD 28.4) of students who did not undertake additional research (p = 0.0237). Furthermore, the predominant type of programs the student interviewed with (i.e., programs with an academic versus community focus) had a significant impact on the proportion of interviewers who asked about the SP. Students applying to “almost all” or “more than half” of programs with an academic or research focus had a greater proportion of interviewers (31%, SD 27.9) asking them about their SP versus interviewers of students (22%, SD 25.5) who reported applying to “none at all” or “less than half” of programs with an academic research focus (p = 0.0054).

Table 4

Factors Impacting Mean Reported Proportion of Interviewers Asking about the Scholarly Project
	Proportion of Interviewers Asking about SP (%, SD)	p-value
Type of Specialty		0.2221
Primary Care	33% (28.1)
Non-Primary Care	23% (25.6)
Competitiveness of Specialty		0.2856
More Competitive	18% (26.3)
Less Competitive	29% (29.9)
Publication Status		0.9005
Published	27% (27.0)
Not Published	26% (27.1)
Presentation Status		0.1876
Presented	34% (30.4)
Not Presented	23% (24.1)
Topic Relatedness to Specialty		0.4553
Topic Related	30% (27.2)
Topic Unrelated	24% (26.7)
Amount of Research Undertaken		0.0237
Additional Research	50% (26.2)
Only Scholarly Project	29% (28.4)
Type of Residency Programs		0.0054
Almost All - More than Half Academic Programs	31% (27.9)
None - Less than half Academic Programs	22% (25.5)

This study provides unique insight into the impact of research experiences on the residency interview discussion. Our data show that 40% of interviewers asked students about their research experiences, providing evidence that discussion of these experiences may provide interviewers with insight into students’ critical thinking skills and ability to be self-directed independent learners. This supports the previously demonstrated observation in the literature that students with a greater number of research experiences are more likely to be successful in the NRMP match.¹ These findings also challenge applicants to view these experiences as more than simply a bullet on their resume but rather as a dynamic piece of their application through which they can demonstrate positive attributes to programs during the interview.

Specifically, amongst our cohort of medical students who had completed a mandatory, longitudinal scholarly project, approximately one-third of interviewers utilized this as a discussion topic during the residency interview. This may encourage additional medical schools to consider implementation of a scholarly project within their curriculum to provide additional experiences through which their students can shine in the interview process. Additionally, a student’s chosen specialty, competitiveness of specialty and relatedness of SP topic to their chosen specialty had no significant impact on the proportion of interviewers inquiring about their SP. This may indicate that interviewers are more interested in the types of skills and traits developed through undertaking a scholarly endeavor than the actual topic of the research. Furthermore, this observation may serve to diminish the notion that research is not important for students applying to primary care specialties. Overall, a mandatory scholarly project during medical school appears to benefit students during the interview process regardless of type of specialty they apply to and the relatedness of their research topic to this specialty.

As NRMP data suggests students with a greater number of publications and presentations are more likely to be successful in the match than their peers¹. This may lead students to believe that research is only valuable on their application if these milestones are obtained, however, the findings of this study suggest that research may be important as a discussion topic during the interview regardless of whether it received publication and presentation status. It is likely that interviewers see value in discussing these academic endeavors with students regardless of the project’s result.

There are two circumstances in which students may anticipate a greater number of interview questions about their SP. First, if the residency setting is academic the percentage of interviewers asking about a student’s SP increases from 33–50%. It is understandable that interviewers at academic programs may use research endeavors to learn more about an applicant’s attributes while interviewers at community programs may utilize alternative discussion topics to get to know the applicant. Second, students who undertake additional research beyond their mandated SP receive a greater number of interview questions about the topic compared to those students who do not undertake additional research, 50% compared to 29%, respectively. It is reasonable that with research experiences making up a more substantial piece of these student’s extracurricular activities, the SP, as a piece of the research portfolio, becomes a more frequent part of the interview discussion than students who only completed mandatory research requirements.

Limitations:

While multiple interesting observations can be noted from the results of this study, there are numerous limitations including a small sample size of residency applicants from only a single medical school. The retrospective nature of the survey lends itself to recall bias in which survey participants may not have been accurate in their estimations of the number of interviewers asking them about their experiences. There was range of one to four months between student completion of interviews and participation in the study survey. Despite these limitations, this study provides some of the first quantitative observations about the topics of discussion during the residency interview. Its observations will help to guide future medical students within our institution with regards to the impact of their scholarly project in the residency interview and it is our hope these observations may have utilization for research programs at other schools of medicine as well.

Student research experiences may serve as a meaningful discussion topic during the residency interview. Approximately one-third of interviewers ask about the scholarly project regardless of type of specialty, competitiveness of specialty, topic relatedness of project, and publication/presentation status of project. Students with additional research experiences beyond their scholarly project may experience up to half of interviewers asking about their scholarly project whereas students applying to community programs with less academic/research focus may experience fewer questions about research compared to their peers applying to more academic programs. These findings have implications for medical students as they choose research projects and medical school administrators as they consider the impact of research on the success of their students in the residency match.

NRMP = National Residency Match Program

SP = scholarly project

UACOMP = University of Arizona College of Medicine – Phoenix

SD = standard deviation

MSPE = Medical Student Performance Evaluation

Ethics approval and consent to participate:

This study was approved by the University of Arizona Institutional Review Board. Additionally, the survey administered was approved by the Office of Assessment and Evaluation at the University of Arizona College of Medicine – Phoenix. All study participants signed an electronic informed consent prior to completion of the study survey. All methods were carried out in accordance with relevant guidelines and regulations.

Consent for publication: not applicable

Availability of data and materials:

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Competing interests:

The authors declare that they have no competing interests.

Funding: not applicable

Authors' contributions:

KD collected and analyzed data, and was a major contributor in writing manuscript, MM oversaw collection and analysis of data and contributed in writing manuscript. All authors read and approved the final manuscript.

Acknowledgements:

Thank you to Paul Kang for providing statistical advice, Cristal Cathey for IRB submission assistance and the entire Scholarly Project Team at the University of Arizona College of Medicine - Phoenix.

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Kaur, P, Hartnett, E, Wypiszynski, S, & McEchron, M (2020). Components of the Required Scholarly Project for U.S. Allopathic Medical Schools. American Medical Association.
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No competing interests reported.

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You are reading this latest preprint version

The impact of medical student research as a discussion topic during the residency interview process

Status:

Version 1

Abstract

Background

Methods

Results

Conclusion

Figures

Background:

Methods:

Statistical Analysis

Results:

Baseline Characteristics

SP Impact on the Interview Conversation

Discussion:

Limitations:

Conclusion:

Abbreviations

Declarations

References

Additional Declarations

Status:

Version 1